I'm in an RN program and I could use a little advice. Before starting the RN program, I worked in a hospital as a nurse aide in med-surg and hated it. I also work in a primary care clinic (mostly in pediatrics, some in family practice) as a medical scribe and I really enjoy it. It's early at this point and I just finished my rotation at a SNF, but I still dislike everything about bedside care.
I really like the patient flow and the vibe of the community clinic I work at. Patients come in, they get help, then they leave instead of needing to be tended to and monitored all day and all night. Obviously there are patients who need to be in hospital, and those hospital nurses are great, but I don't feel like that's a good fit for me personally. My clinic job is not easy and most days everyone hustles pretty much all day. We see about three patients per hour depending on complexity, but generally we see them one at a time. My previous job at the hospital was just crazy busy, especially for aides like me with 10 to 12 patients each. I'm never doing that again if I can help it.
Should I try for a new grad job in public health or primary care without doing time in a hospital first? I could probably do a couple years in hospital if absolutely necessary to gain experience, but I'd rather not. In the hospital setting I felt stretched too thin with too many patients to care for at once, and the nurses were not impressed with my performance (mainly my speed) even after a year. In the community clinic, it took only a few months before everyone respected me and wanted me to be their scribe. I'm very concerned that if my first job is in a hospital, I'll do poorly and get a reputation for mediocrity that might have a lasting negative effect on my nursing career.
I'm a bit torn by what I hear about the ICU. It's bedside care but only one or two patients at a time, and I've heard you get great experience doing detailed assessments which increases your medical knowledge. However the ICU patients are fragile and very ill, so they have multiple problems to manage and as a new grad maybe i would not have the necessary knowledge to care for them.
At the clinic where I work they just hired a new grad RN to train as a pediatric triage nurse, so I know at least a few of those jobs are out there. However, they tried this several months ago with another new grad RN and she quit for a hospital job saying she felt like she needed the experience. The veteran pediatric triage nurse does have misgivings about new grads in triage without hospital experience. The RNs in the clinic do mostly triage and case management but also help with catheterization, etc. I actually love talking to patients. My dream job would probably involve wellness checkups, triage and patient education.
Helpful advice is much appreciated. Telling me I'm lazy for wanting a day shift clinic job or that I simply won't be a real nurse if I don't do bedside care is probably less helpful, but if that's the way you feel go ahead and share. I'm so sorry for this long post I can't stop writing! Thank you for any help!
Specializes in Flight Nursing, Emergency, Forensics, SANE, Trauma.
Even if it's "possible" it is NOT good advice. Home health ,school nursing, and camp nursing require assessment skills that require a lot of experience. The nurse will be the only health care professional assessing the kidlet/patient.
I tried home health care after 20+ years of experience... did not want to stick my neck out that far... for $40 a visit.
I can honestly say... I was a camp nurse with only an EMT certification when I was 21. In retrospect-- that's freaking scary. I had 150+ people a week I was responsible for, had a boat load of kids to medicate. I was not enough. Thankfully the Girl Scouts changed their requirements because it just wasn't safe and my administration didn't back me when I wanted to send someone to the hospital half an hour away because it "cost money to gas the van" and it took away staff members.
It seems I've seen more threads lately from potential nurses that don't really want to work as nurses. It may not be impossible to find work away from bedside nursing right out of school, but I don't think that it is likely. I guess my question to you and the others that are posting this question is if you really don't ever want to work providing patient care as a nurse, why would you even want to be a nurse?
I work in a clinic for community health and am hoping to get an MPH and eventually a PhD in public health. I don't plan to work as a clinic nurse forever, but I am happy to be gaining the experience I am getting. I have always worked in community health and psych. Is my experience not real nursing work to you because I don't work in a hospital?
I am a CNM who is full time in a clinic setting, and I moonlight as an RN in LDRP as well.
I agree that there is no shame in not wanting to do floor nursing. I have only ever worked in reproductive health, and do not enjoy working in medsurg or ER at ALL. I love taking care of people and have no qualms about doing any sort of personal care, and in fact I love being able to get someone clean and comfortable, and provide them with gentle touch and a little TLC. But, I find doing extensive ADLs on multiple patients to be draining and not enjoyable. Patients who need extensive assistance with ADLs are the exception in LDRP (babies don't count because who doesn't love taking care of fresh little newborns?), so it never feels like a chore when we do have a mom who needs that level of assistance.
To be honest, I find juggling a med/surg or ED nurse/patient ratio to be exhausting, ADLs or not. I would not find professional satisfaction in that type of job; I just don't have the chops for it I guess, and I am infinitely in awe of those who do.
I love love love love the outpatient setting, both when I did it as an RN and now as a CNM. The pay as an RN was not great though. I did home care for a while too, and being 1:1 made personal care no big deal, but the job itself was terrible (even though my little patients were awesome). But something to consider as a new grad.
Hello! As a nurse myself and having been to nursing school as well, I know first hand that patient care is a very hard thing to do day in and day out. I also know and realize that working in the hospital is very hard now because they expect a nurse to work 12 hour shifts and rotate from day to night shift as well which is very hard for some people. It would be very hard for me to do that because I have to sleep at night due to my medications and I could not stay awake during the graveyard shift at all. If you like the clinic job that you were describing which gives you more day hours and less patient care, then take that position or take any job or position that is a right fit for you and your life style. You can go for any job that you want to as long as it keeps you physically and mentally healthy. It you have a job that does both of those for you, then you are in great shape. It is important to have a job that keeps you physically and mentally healthy because that way you can help other people and be able to treat your patients. It is also important to keep in mind of other options that you might be interested in such as those that you mentioned. Researching things that you would like to do is very important because it makes people love what they do and it keeps the passion for nursing alive. I believe that you are on the right track. Just remember that whatever you feel most comfortable in doing is what you should do for your job. Keep up the good work and the best of luck to you. Marcella 5/19/16
Nurses today have a lot more options than they did many years ago. Years ago, nurses just worked in hospitals, nursing homes, and doctors offices and wore the white hats that they wore on their heads. Now, nurses have so many more options to choose from and they do not have to see patients in order to be a nurse. My role of nursing is through research and writing. I have already been doing the patient bedside care. I did geriatric nursing bedside care and school nursing care. Now, I take those skills that I have done in the past and use them for my research which I am doing today. I also take those bedside skills and use them in my writing which I also do today as well. Today, nurses can work from their homes and do telephone nursing or give advice on forums via telecommute. Also, nurses can do research for NIH and write research papers. They can work for the government as well if they would be open into doing so. There are so many different options available today. My best advice to give you would be to do a search on the internet and see what the internet comes up for "nursing that does not do patient care." I bet that there are many things that come up and can help you find what you are looking for. Best of luck to you and I hope that you find what type of nursing job that you are looking for. Marcella 5/19/16
Nurses today have a lot more options than they did many years ago. Years ago, nurses just worked in hospitals, nursing homes, and doctors offices and wore the white hats that they wore on their heads. Now, nurses have so many more options to choose from and they do not have to see patients in order to be a nurse. My role of nursing is through research and writing. I have already been doing the patient bedside care. I did geriatric nursing bedside care and school nursing care. Now, I take those skills that I have done in the past and use them for my research which I am doing today. I also take those bedside skills and use them in my writing which I also do today as well. Today, nurses can work from their homes and do telephone nursing or give advice on forums via telecommute. Also, nurses can do research for NIH and write research papers. They can work for the government as well if they would be open into doing so. There are so many different options available today. My best advice to give you would be to do a search on the internet and see what the internet comes up for "nursing that does not do patient care." I bet that there are many things that come up and can help you find what you are looking for. Best of luck to you and I hope that you find what type of nursing job that you are looking for. Marcella 5/19/16
That's all well and good, but you had bedside experience before you found the good job. You had the skills.
There's a disturbing number of nurses now who want to skip straight from school to research, writing, case management, phone triage, etc, and never actually have to touch (eewww, gross!!) sick people.
I've run into new grads who have no clue how to insert a Foley or NG, have never listened to lung or bowel sounds, and can barely string three words together to form a coherent sentence when they chart.
How in the world are they supposed to function in any of the jobs I mentioned??
Yes, our system equips us with a triage tool but we can't just rely on it. We need to use our nursing judgement to adequately triage.
I can see how this would be hard for a new grad without experience but hopefully if you've made the most out of your 3 years in nursing school and your preceptorship by taking every opportunity possible then you'll be in a better spot.
Having urgent care background as an LVN helps, too!
I am personally still going to seek out my "one year on the floor" once I'm done with my program but that's because I personally feel it would benefit ME to become a better nurse. I work with plenty of RN's, however, who have never worked at the hospital and they are amazing nurses with top notch triage skills! Some people just have it and apply themselves through continuous education and learning experiences I suppose! 😂
Reading between the lines, she doesn't want to get her hands dirty, literally. How is she handling clinicals???
This is how you have a student say "I never gave an injection" the week before pinning! I think nursing schools are doing a disservice to the students and the profession. Orientation for a new grad should involve planning and time management, not teaching basic nursing skills.
Your "between the lines" reading is not providing you with an accurate portrait of me. For $35 an hour, I'll change diapers or insert catheters all day. However, I do not like the idea that while I'm doing that I've got four other patients sitting in poop, lying in pain waiting on me to give a pain med or having increased difficulty breathing while I run around like crazy with only one or two aides on the floor. Time management is an important skill, but how about hospital management providing better staffing so I don't have to skip breaks and drink two Monster drinks per shift just to keep up!
Keep an eye out for clinics which may be hiring Specialty MDs/DOs or Primary Care Providers. Those Providers will all need a Triage Nurse or Rooming Nurse (typically LPNs)- if you can sell your skills from inpatient nursing which rounds out your clinic experiences, you may be able to show them it's worth hiring you. Make friends with Pharmacists hired as Medicine Therapy Management personnel (teach patients about new meds prescribed or overall medication management and teaching); they could teach you a lot. Take extra classes on diabetes, see about getting certified as a Diabetic Educator so you could teach patients about managing various stages of pre-diabetic and actual diabetic diagnoses.
Take heart; nursing schools have to get 'with it' and start including ambulatory concepts and having ambulatory clinical time. Way back when I was a new grad 30+ years ago, 'they' were saying then that clinics of the future would be as big as hospitals were then and hospitals would be a small as clinics were then. I am seeing clinics adding floors building UP and no more hospital additions/expansions because the focus has been outpatient treatment and NOW there are governmental financial rewards for keeping patients OUT of the hospital. Pretty soon, there will be much FEWER opportunities for inpatient care. Go get, 'em, Lemon Bars!
This will allow you to make a generally higher wage than the average floor nurse, will be challenging in its own respect, and will eliminate the long term/bedside care of the client.
Although I would HIGHLY recommend at least two years of floor nursing beforehand, with at least 1 or both of those years being in an ICU. This will give you much better assessment and critical thinking skills, than just working in a clinic, or even jumping directly into procedural nursing, which can be harder without requisite critical care experience.
Scrubs_n_sirens, MSN, RN
136 Posts
I can honestly say... I was a camp nurse with only an EMT certification when I was 21. In retrospect-- that's freaking scary. I had 150+ people a week I was responsible for, had a boat load of kids to medicate. I was not enough. Thankfully the Girl Scouts changed their requirements because it just wasn't safe and my administration didn't back me when I wanted to send someone to the hospital half an hour away because it "cost money to gas the van" and it took away staff members.